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18 June 2017

Person and Ovesey follow the old psychoanalytic tradition of referring to
trans persons by their birth gender, and thus a heterosexual trans woman is in
their terminology a ‘male homosexual’.

Development model

Person and Ovesey were influenced by the development model of psychoanalyst
Margaret Mahler, and
from this proposed that a child's separation-individuation anxiety produced a
fantasy of symbiotic fusion with the mother which the transsexual tries to
resolve by surgically becoming her mother.

“The male transsexual is defined by most workers as having a female core
gender identity. From our experience, it seems more accurate to say that
transsexuals have an ambiguous core gender identity. … [this] permits the
disorder to be conceptualized psychodynamically in conflictual terms as a
neurosis. In our opinion, transsexualism originates in extreme separation
anxiety occurring early in life, before object differentiation has been
accomplished. To alleviate the anxiety, the child resorts to a fantasy of
symbiotic fusion with the mother. In this way, mother and child become one and
the danger of separation is nullified. We believe that this reparative fantasy
is the psychodynamic basis for transsexualism in the male and that the
transsexual phenomena can be understood clinically as attempts to ward off
threats to psychic fusion with the mother.” (p 107-8)

Typology

They proposed a typology of transsexuals as follows (as summarized by
Vitale):

1 Primary - functionally asexual and who progresses resolutely toward a
surgical resolution without significant deviation toward either homosexuality or
heterosexuality, no evidence of effeminacy in childhood.

2a Secondary, homosexual - effeminate from earliest childhood, preferred
girls as playmates, avoided boyish pursuits and were "mother's helpers."
Crossdressing began in childhood, initially for narcissistic satisfaction, but
later at puberty to attract male sexual partners. Cross-gender fantasies were
frequently tied to identification with movie actresses and drag queens. The
authors note that the homosexual cross-dresser wants to be noticed and to this
end often wears flamboyant and colorful clothing and engages in theatrical
endeavors.

2b Secondary, transvestic - appropriately masculine, and occasionally
exceedingly hyper-aggressive and hyper-competitive. They neither played with
girls nor engaged in female pursuits. They fantasized about being girls when
cross-dressed, but valued their assertiveness and maleness.
This typology was in contradistinction to Stoller’s writings where the
homosexual early transitioner was regarded as primary.

Trans men

With regard to trans men, Ovesey and Person write:

“we have concluded from a study of female transsexuals that there is no
female equivalent of primary male transsexualism. In our opinion, the
transsexual syndrome in women develops only in homosexuals with a masculine
gender role identity. Female transsexualism, therefore, can be classified as
another form of secondary (homosexual) transsexualism.” (p 112)

Homosexual transsexuals

Of male homosexuals, Person and Ovesey write:

“The vast majority of male homosexuals lack the propensity for a transsexual
regression. The propensity exists almost entirely in cross-dressing effeminate
homosexuals who comprise a very small segment of the homosexual population.”

They divide homosexual transsexuals into two subgroups:

a) passive effeminate homosexuals who

“in many ways present a caricature of typical female norms. They are
interested in such things as cooking and decorating, but most of all, they seek
a love relationship with another man where they can assume the female role. … on
the surface they are passive and dependent, but they often dominate their mates
through oversolicitousness. In this respect they, they tend to duplicate the
close-binding behaviour frequently ascribed to their mothers. Often a
relationship is terminated because the lover feels suffocated.”

b) the more aggressive, though equally effeminate, drag queens. They

“are usually involved in a community of other queens. They treat each other
as ‘sisters’, and sexual relations within the group are rare. …. Narcissism is
institutionalized in an endless series of drag balls and parties. … The queen
claims that he wants involvement with a hypermasculine man who will overpower
him …[however] he frequently prefers to be the active partner in anal
intercourse. … These queens are quick to violence, both verbal and
physical.”

Two examples are given: C. a 33-year-old who lives with mother and has worked
only two years in his life. He met a man in Spain while on holiday and maybe the
man would marry him if he had the operation. D. works as a drag queen and also
turns tricks. His family know that he is gay, but not the rest. He has lost
interest in sex, but hopes that post-op he would find a ‘real man’.
(p 127-135)

Transvestic Transsexualism

“transvestic transsexuals have the typical personality structure of their
parent group, transvestites. The personality is organized on an
obsessive-paranoid axis with attenuation of both tender affectivity and
sexuality. These patients are hypercompetitive, may be hypermasculine, and
engage in endless struggles for power with other men. … The relationship with
the wife is essentially dependent. As such, its success is determined by the
personality of the wife and her capacity to tolerate both cross-dressing and
minimal sexuality. … Mental life is characterized not only by irritability and
preoccupation with power struggles but also by bouts of depression. … they are
countered most frequently by cross-dressing and many instances by resort to
alcohol. … Suicide attempts are common, as we would expect in a patient
population so prone to depression.” (p135-142)

Transvestism

Person and Ovesey went with the definition that transvestism is done by male
heterosexuals (not gay men nor women) for fetishistic sexual arousal, although
they concede that it may also be done ‘to relieve anxiety about gender role
identity’. They divide transvestites into masochistic and non-masochistic. The
psychoanalyst Milton Jucovy had proposed the concept of ‘initiation fantasy’ as
a central part of male transvestism. Person elaborated that there are two
versions: forced initiation by a dominant, big-breasted, booted phallic woman,
and also initiation by a kindly woman who dresses the man to save him from
‘Mafia killers’ or some such.

DSM III

In 1978 the Archives of Sexual Behavior published Virginia Prince's
"Transsexuals and Pseudotranssexuals" in which she proposed that the only true
transsexuals are asexual, socially-inadequate men who would function better as
women, as "less is expected of women". She presumed that bisexuals (2,3,4 on the
Kinsey scale) of their nature do not become transsexuals. She also proposed two
kinds of 'pseudotranssexual' based on sexual orientation.

"The preoperative homosexual group (Kinsey 5,6) gave much higher scores on
all questions dealing with sex and lower scores on those questions dealing with
gender, while those in the heterosexual group (Kinsey 1,2) gave high scores to
gender type questions and much lower scores on the sex type questions".

The third edition of the Diagnostic and Statistical Manual of Mental
Disorders (DSM III) 1980 added transsexualism for the first time, and
subdivided it into asexual, homosexual, heterosexual and unspecified. Thus it
was roughly congruent with Stoller, Person-Ovesey and Prince. Furthermore
‘transvestites’ was defined as done by a heterosexual male. Again congruent with
Stoller, Person-Ovesey and Prince. However to the chagrin of Prince (who had
been insisting on a differentiation from fetishism) it was defined as done for
sexual excitement.

Robert Stoller. Sex and Gender. Science House, 1968.

Ethel S. Person. “Some Differences Between Men and Women: We think and
behave different for biological and psychological reasons, not just cultural
ones”. The Atlantic, March 1988. Online.

Surely the non-homosexual transsexual group should have been called
‘heterosexual transsexuals’ or even better ‘gynephilic trannsexuals’. To put
‘transvestic’ in the type name predisposes to a negative interpretation just as
much as calling them ‘autogynephilic’.

I have previously commented on similar attempts at typology. See Kay Brown androphilic
and gynephilic,
and Anne
Vitale. I still think that 3-part typologies of transsexuals are better than
Blanchard’s 2-part – but I am certainly not recommending the Person-Ovesey
model. Vitale’s model regards the pathology as gender deprivation anxiety -
non-standard gender identity as such not being a pathology. Thus Vitale’s
approach is preferable if we are to continue with typologies. Those who
transition as soon as possible, those who spend some time living as gay before
transition and those who marry and have children before transition are
intuitively three different types. However to define the three types by
adding psychoanalytical interpretations and to ignore the great variety within
each type ends up defaming all and sundry. The intuition of three types does
lead to some valuable insights, but to reify the three types leads to severe
distortion.

In part I, I mentioned Elizabeth who writes Notes from the T Side.
Apparently she is a Benjamin
VI (High Intensity True Transsexual), a Vitale G1 and a Stoller Primary; but a
Person-Ovesey Secondary and a Prince Pseudo-transsexual. This is an excellent
example of how typologies should not be taken literally.

I am not aware of any trans persons who actually identity with the Person-Ovesey
model. Rachel
Webb identied as a ‘constructed woman” as per Janice
Raymond; Kay
Brown and Kiira
Triea identified as Blanchardian HSTS; Anne
Lawrence, Willow
Arune, and probably Maxine
Petersen self identify as autogynephiliacs. But no-one has in public
identified as a Person-Ovesey secondary transsexual. This despite the fact that the Person-Ovesey papers came out over a decade before Blanchard's.

It is difficult to reconcile the portraits of all three types of transsexuals
as described by Person-Ovesey with the range of creativity and achievement of
individuals featured in this Encyclopedia. Apparently Person was charming and
easy to get on with face-to-face. However when you read the descriptions of
trans persons in her book, then obviously she was not so nice.

Furthermore, the typology that Person-Ovesey come up was far from original. In its basic structure adheres closely to street stereotypes current at the time. All Person-Ovesey really did was revise the psychoanalytic dialectic to support the model. This despite Person being credited for doing field work in porn shops and transvestite parties! How come she never saw those of us who do not fit into the model - and I strongly argue that those of us who do not fit are the majority. She must have worked at ignoring those of us. This is later called erasure. Yes, there are some trans people who are like those described. There are some who have the separation-anxiety neuroses described. There there are even more who do not.

I have not found any record of Benjamin’s reactions to the 1974 Person-Ovesey
papers on Primary and Secondary Transsexuals.

We should remember that two decades earlier, Benjamin had provided a few of
his patients to Federick
G Worden & James T Marsh who quite disappointed the volunteers and in
effect refused to listen to them, because they knew in advance what transsexuals
were.

The New York Times obituary says: “Her work, upsetting the
conventional thinking, found that many transsexuals and transvestites did not
perceive themselves as homosexuals but rather saw themselves in many different
lights — sometimes, for example, as a woman trapped in a man’s body, and
sometimes as a heterosexual who preferred a feminine demeanor.” Surely this and
more had been established by Magnus Hirschfeld over 50 years before.

Molly Hacker commends Ethel Person in her book about her trans sibling. But
did she never read Person’s book? Does she actually regard her sibling as a
‘transvestic transsexual’, in effect a fetishist? If she does not, how can she commend Person in her
book?

This is Anne Vitale’s summing up of Primary and Secondary Transsexualism:

“It is with dismay that I continue to encounter individuals with gender
identity issues using the terms Primary and Secondary Transsexualism as
diagnostic indicators. The terms show up repeatedly in Internet chat rooms, in
the Internet news groups, in my email, and by individuals presenting to me in my
private practice. The individuals who self-identify as Primary Transsexuals are
usually using the term to mean that they are "Benjamin Type VI, true
transsexuals." Those who self-identify as Secondary Transsexuals are usually
trying to diminish their condition and to find some way to deal with their
gender dysphoria without having to face the possibility of transitioning. As we
shall soon see, neither term has ever had anything to do with severity or
prognosis. There is no hierarchy of transsexualism. There are no Primary
Transsexuals or Secondary Transsexuals. There are only gender dysphoric
individuals who need help.”

1 comment:

Zagria for my money Anne Vitale's categorization is clearly the best although as you rightly mention many patients defy these simplistic models that are most often used to either elevate one's status or conversely downplay it. The reality is that we know very little about transsexualism and using groupings is nothing more than shuffling cards while the real work still remains.

But if I had to pick it would be Vitale's who also clearly tips her hat at the grandfather of our modern day understanding Harry Benjamin.

If you are looking for the most flawed that's easy - Blanchard by leaps and bounds.

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About Zagria

I have a social science degree. I spent several years in the 70s doing Gay Lib counselling, and moved on to organizing trans groups. I was rejected by the Clarke Institute (now CAMH) in the mid 1980s, probably because I do not match either of their stereotypes, but was accepted by Russel Reid on our first meeting in late 1987, and had surgery from James Dalrymple some months later. I have mainly worked as an IT consultant. I have been with the same husband for 45 years.